Reality check: Is it safe to use marijuana during pregnancy?

Cutting out illicit substances like alcohol, cigarettes and drugs is a no-brainer for most women when they learn that they’re pregnant (or are trying to get pregnant). But for a small subset of moms-to-be, one illicit substance in particular has been touted as a lifesaver: marijuana.

It was for Melissa, a Boston-area mom of two who had hyperemesis gravidarum, the same severe morning sickness that Kate Middleton experienced. Although pot wasn’t her first solution — her obstetrician prescribed medications that didn’t end up working — it was the only thing that could stop her from “constantly” vomiting, she told Yahoo Beauty.

“I talked to my friend’s neighbour, who is a midwife, and she said that [marijuana] was the only thing that got her through her first trimester,” Melissa said. “So I smoked a little bit of weed. I coughed, and the coughing made me throw up. But after that, the symptoms just disappeared. It was amazing.”

Eventually, Melissa turned to edibles (she baked small amounts of pot into brownies), and she said it “saved my pregnancy, basically.”

She isn’t alone in her unconventional choice of recreational activity. In a report published in JAMA in January, researchers at Columbia University found that 3.9 per cent of American women who are pregnant report marijuana use, while another recent U.S. study conducted by the National Institute on Drug Abuse found that teen girls are twice as likely to smoke pot if they’re pregnant. Overall, six per cent of pregnant females aged 12 to 44 reported using marijuana in their first trimester.

Things don’t look too innocent in Canada, either. A 2015 publication by the Canadian Centre on Substance Abuse (CCSA) quoted a Canadian Perinatal Health Report (2008) that said five per cent of women used illicit drugs during pregnancy (although it didn’t specify how many used cannabis). But cohort studies suggest that number is considerably off, and state that 10 to 16 per cent of middle-class women and 23 to 30 per cent of inner-city dwellers consume marijuana during pregnancy.

“The 2013 Canadian Tobacco, Alcohol and Drugs Survey found that 22 per cent of women of childbearing age (15 to 44) reported using cannabis in the past year, which shows the potential number of women who are using it during pregnancy,” says Dr. Amy Porath, director of research and policy at CCSA. “And we know the negative impacts of prenatal marijuana use on the fetus continue into late adolescence and early adulthood.”

The impacts include neurocognitive effects as well as behavioural ones, and start to display themselves as early as 18 months. Porath says girls born to mothers who consumed marijuana prenatally show aggressive behaviours and attention problems at 18 months, while all kids show deficits in memory and verbal skills at age three. By the time they turn six, they display impaired verbal performance, quantitative reasoning, and short-term memory, and at nine, there are deficits in reading, spelling and academic performance.

Once they get to their late teens and early 20s, these neurocognitive impairments persist. Behaviourally, they display hyperactivity, impulsivity, delinquency, and even anxiety and depression throughout their lifetime.

“There’s growing research in this area and as more studies come out, they come to the same conclusions, strengthening what we already know,” Porath says. “There’s definitely a reason to be concerned.”

In the case of hyperemesis, Dr. Jennifer Blake, CEO of the Society of Obstetricians and Gynaecologists of Canada, says that any claims that marijuana helps are purely anecdotal and misleading.

“The problem with severe nausea and vomiting is that it gets better eventually,” she says. “In most women, it devolves over time, so even if someone tells you that she took it and felt better, you don’t really know what made her feel better.”

Supporters of marijuana use in pregnancy often turn to a surprising study conducted in Jamaica in 1994. It found that babies whose mothers consumed the drug during gestation had better physiological stability, were more alert and less irritable at one month compared to babies who weren’t exposed to marijuana.

However, experts are quick to point out that the study was small (only 24 marijuana users and 20 non-users were monitored), and it’s difficult to know with certainty who’s telling the truth. As Blake says, it’s hard to get a full picture when you’re asking people to report on something that’s illegal.

There’s another factor to consider when pondering the use of marijuana during pregnancy: you never really know what you’re getting.

“The research we have is based on what we know about cannabis, but the problem is people never really know what they’re purchasing,” Blake says. “They’ve found fentanyl contaminants in samples purchased from dispensaries — there’s organized crime in the supply chain there. More effort needs to be put in the situation.”

And yet, some women swear they couldn’t have made it through their pregnancies and tolerated their extreme nausea if they hadn’t turned to pot. Carly, a Kawartha region mom, had hyperemesis in both her pregnancies — in her first pregnancy, extreme nausea and vomiting caused her to lose 30 pounds, in her second, she lost 20. So, she smoked just enough marijuana to curb her nausea and allow her to eat. She smoked up until her 17th week of pregnancy, and in both cases gave birth to healthy babies.

“I wish more women would turn to this amazing, natural plant medicine during pregnancy and the stigma behind it vanish, because it can help so many, naturally,” she says.

Lianne Phillipson, a registered nutritionist and founder of Sprout Right, hasn’t had any clients come to her seeking advice on tempering hyperemesis with cannabis, but she says “I don’t know how I would have handled that kind of situation if I were in their shoes, especially understanding the need of nutrition for a growing fetus.”

However, she says, there are ways to circumvent morning sickness naturally — and not in the “natural” way some women do. She advises her clients to take B6 and ginger and to eat protein.

“Eat as large a quantity as you can of protein, whether it’s meat, eggs, soy or dairy, as it helps clear the hormones that are building up in your liver, which is often the cause of nausea,” she says. “Eat often and don’t let yourself get hungry. If you need to eat dry toast or a cracker to get over the nausea, do that and then eat some protein. Grab any opportunity you have to eat something healthy.”

She also says that “the human body can do amazing things,” and many women have experienced severe morning sickness without turning to marijuana. And they, too, had healthy babies.

Blake sums it up simply by pointing out, “when you’re pregnant, you’re making choices that your baby has no say in. These are critical developmental moments for your baby. It’s the time to do the very best that you can.”